Doctor Name: | DEANNA SUE DUDENBOSTEL |
NPI Number: | 1518914845 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMD |
License Number: | DS028846L |
Business Practice Address: | 2621 N Broad St Suite B Colmar, PA - 189159401 |
Business Phone Number: | 2158226777 |
Business Fax Number: | |
Mailing Address: | 452 Redbud Ct, WARRINGTON |
State: | PA |
Postal Code: | 189762623 |
Phone Number: | 2154918623 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2006 |
NPI Last Update Date: | 10/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DS028846L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |